1. Field of the Invention
The invention relates generally to the field of medical needles and methods of using the same.
2. Background Art
Minimally-invasive medical procedures have had a dramatic increase in popularity. This popularity is partly due to decreased complications from the procedures, a shortened recovery time for the patients, and a lower cost for the procedures. A great deal of new technology has been developed for these minimally-invasive procedures including electrodes, catheters, surgical tools, cameras, lasers, heating and cooling mechanisms, probes, cutting tools, lights, and other types of apparatus that can be passed through the lumen of a needle in order to carry out a variety of procedures.
Copending U.S. application Ser. No. 09/921,179, filed on Aug. 2, 2001, discloses a needle comprising a hollow shaft having opposed distal and proximal ends, the hollow shaft having a lumen extending from the proximal end of the shaft and terminating at an opening on a top of and proximal to the distal end of the needle shaft. A cutting surface is at the distal end of the hollow shaft adapted to be inserted into a patient, wherein the cutting surface is on the bottom of the distal end of the hollow shaft. Copending U.S. application Ser. No. 09/921,179 is incorporated herein by reference in its entirety.
U.S. Pat. No. 4,141,365 discloses a tissue stimulation apparatus for positive positioning of an electrode-bearing lead proximous to tissue which is to be stimulated electrically. The apparatus particularly includes a body penetration and insertion assembly which carries an elongated flexible strip of physiologically inert plastic material having at least one electrode positioned thereon into contacting relation with said tissue. The insertion assembly comprises a hollow needle having a slot formed longitudinally along the length of one wall thereof, the slot allowing transverse removal of the flexible lead from the needle after proper positioning of the lead and after removal of the needle from the body. The slotted assembly allows use of a flexible electrode lead having electrical connections at the external end thereof which are too large to pass through the hollow needle. U.S. Pat. No. 4,141,365 is incorporated herein by reference in its entirety.
U.S. Pat. No. 5,255,691 discloses an improved method and apparatus for introducing a flexible member into the epidural space of the spinal column of a patient employing an introducer assembly for achieving access to the epidural space. The introducer assembly includes an epidural needle assembly, including an elongated needle having a side opening at its distal tip, a hub at its proximal tip and a lumen extending therebetween, and a stylet removable and insertable within the lumen of said needle through said hub and having a beveled tip and a hub. The distal tip may be curved in the direction of the side opening when unrestrained by the stylet. The introducer assembly has a locking mechanism which preferably includes a lug extending from the side of the needle hub and an L-shaped cut-out in the side of the stylet hub for receiving the lug therein and allowing its rotation 90° to effect a bayonette-style locking of the two hubs. U.S. Pat. No. 5,255,691 is incorporated herein by reference in its entirety.
U.S. Pat. No. 5,433,739 discloses a technique of relieving back pain by heating of an intervertebral disc. The heating is illustrated by a percutaneous technique where a needle or electrode is inserted into the disc under X-ray or other imaging control and subsequently used to elevate the temperature of the disc. Above a certain temperature, the innervation related to the disc is destroyed to the point that back pain related to that innervation also can be eliminated. Specific examples of methods and apparatus to achieve such disc heating are given. Among the methods are use of radiofrequency heating and direct current heating, use of stimulation and impedance monitoring to improve target control, and the use of temperature monitoring to determine and quantify the appropriate disc temperature to achieve the desired clinical results. U.S. Pat. No. 5,433,739 is incorporated herein by reference in its entirety.
U.S. Pat. No. 5,730,754 discloses devices and methods for accessing the spinal epidural space via the neural foramen. In one aspect, a deflecting conduit needle device is disclosed having an elongated body extending substantially along a first axis. The device has a proximal end and a distal end, and a transverse conduit, positioned along the distal one-eighth of the device and extending substantially along a second axis, wherein the second axis is positioned at an acute angle relative to the first axis. In another aspect a method is disclosed for accessing the spinal epidural space via the neural foramen. U.S. Pat. No. 5,730,754 is incorporated herein by reference in its entirety.
U.S. Pat. No. 6,010,493 discloses a method of epidural surgery that improves visibility in the epidural space of a patient for more effectively conducting therapeutic surgery therein. The method includes the steps of distending a portion of the epidural space of a patient by filling the portion of the epidural space with a fluid supplied from a catheter and positioning a portion of an optical scope in the distended portion of the epidural space by inserting the optical scope through the same catheter that supplies the distending fluid to thereby provide a visual image of the epidural space. U.S. Pat. No. 6,010,493 is incorporated herein by reference in its entirety.
U.S. Pat. No. 6,104,960 discloses a system and method for providing medical electrical stimulation to a portion of the nervous system. The system includes a rigid hollow needle having a lumen and a flexible lead body disposed within the lumen of the needle, the lead body having an insulated coiled proximal section and an electrode section. The proximal section comprises a conductor which is coiled and insulated, the electrode section comprises a portion of the coiled conductor which is not insulated. In an alternative embodiment, the electrode section features a crimp core around which a distal end of the coiled conductor which is not insulated is crimped, the rigid hollow needle is metal but which is partially covered along its outer surface with an insulation. In still further embodiments, the flexible lead body has a stylet lumen therein and the lead body also has a connector pin for electrically connecting the electrical conductor to a pulse generator. Preferably this connector pin located on a proximal end of the lead body and having a diameter no greater than the inner diameter of the needle. A method of providing temporary electrical stimulation to the sacral nerve is also disclosed. U.S. Pat. No. 6,104,960 is incorporated herein by reference in its entirety.
U.S. Pat. No. 6,233,488 discloses a method for suppressing chemical substance craving that comprises an electrical stimulation of the spinal cord using one or more implantable leads containing at least two conducting electrodes. The method may be used to suppress craving for alcohol, narcotics, cocaine, and amphetamines. The method is particularly suited to the suppression of nicotine craving. U.S. Pat. No. 6,233,488 is incorporated herein by reference in its entirety.
U.S. Pat. No. 6,261,311 discloses a percutaneous method of repairing a fissure in the annulus pulposus that includes placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to fues. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal end of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus. Next the functional element is positioned at a selected location of the disc by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. Then the functional unit treats the annular fissure. Optionally, there is an additional step of adding a substance to seal the fissure. An externally guidable intervertebral disc apparatus also is disclosed. U.S. Pat. No. 6,261,311 is incorporated herein by reference in its entirety.